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State of Color aft <br />County of Ntle— <br />BEFORE ME, the undersigned Notary, SA r ( A , (314., [name of <br />Notary before whom affidavit is sworn], on this <br />[month], 20 . 2 .personally appeared r 7 \C "f-e V S [name of <br />affiantj, known to me to be a credible person and of lawful age, who being by me first duly swam, on V lA S (his or <br />her] oath, deposes and says: <br />1. I am the Managing Partner of 120 85 LLC, a Colorado Corporation. <br />2. We are accepting inert landfill material from approved providers. <br />3. We do not accept any material that does not meet the definition of inert material contained in Rule 1.1(24) <br />Inert Materiall means non -water soluble and non- putrescible solids <br />together with such minor amounts and types of other materials, unless <br />such materials are acid or toxic producing, as will not significantly affect <br />the inert nature of such solids. The term includes, but is not limited to, <br />earth, sand, gravel, rock, concrete which has been in a hardened state <br />for at least sixty days, masonry, asphalt paving fragments, and other <br />inert solids. <br />4. We have posted signs and provide written notice to all persons that deposit material regarding the materials <br />allowed on the site. <br />5. We maintain a daily log of each load and only accept material from jobs that are known to have only dean, <br />inert material. <br />(si <br />a re of tJ <br />Eric B. Fenster, PO Box 44011, Denver, CO 80201 <br />Subscribed and swom to before me, this <br />20 12-. <br />tir!rA�� a • . <br />[typed na ` of Notary] <br />NOTARY PUBLIC <br />My commission expires: <br />( [ ,20 201 (0 <br />GENERAL AFFIDAVIT <br />2 [day of month] day of Cl te Q_ <br />[day of month] day of [month), <br />RECF VPD <br />OCT 05207Z <br />Division v, au0rl, <br />Mining & Safety <br />